Mandates and cost

Most people don't have a lot of money left over when they buy a house. So imagine if, at the last minute, a state official said you'd also have to buy insurance against floods, termites, sinkholes, tornadoes, beach erosion, grizzly bear attacks and loggers dropping big trees on your new home.

A lot of folks wouldn't buy at all.

And this would be doubly frustrating if the house were in arid Southern Nevada, where you might think an adult should be free to form his own estimate of the risks of losing the family home to hurricane, tornado or Canadian loggers.

But this is pretty much what happens when Nevadans go to buy health insurance. State law requires us to buy many coverages most of us will never need, driving up costs.

If you're a single, male Nevadan in your 20s with health insurance you'll be glad to know you're covered for mammograms and reconstructive surgery after breast cancer.

And if you're a young, single woman, you may be just as happy to learn the Legislature has ordered your insurance company to charge you for membership in a group that's insured for the costs of prostate cancer screenings.

Nevada has 44 such mandated coverages, ranking it No. 24 among the states, according to the Council for Affordable Health Insurance. J.P. Wieske, executive director of the council, says such mandates drive up the cost of premiums by 10 percent to 25 percent.

No one is arguing that women shouldn't be allowed to buy insurance plans that cover mammograms if they choose. The question is whether mandates drive up prices to the point where some Nevadans are bankrupted by a single illness or injury because they found insurance unaffordable.

Why not allow people to buy a bare-bones policy? "Who's best able to determine whether something is needed or is appropriate care?" asks Mike Murphy, head of Anthem Blue Cross and Blue Shield in Nevada. "The best way is to leave it to the private sector, including doctors and hospitals."

Indeed, why not let adults of normal mental competence weigh their risks and allocate their assets as they see fit?